Driving Workforce Excellence and Innovation in Senior Care

NIC Chats was live at the 2025 NIC Fall Conference in Austin as Lisa McCracken, Head of Research & Analytics at NIC sat down with Brett Landrum, CEO of Procare HR, for a candid conversation on growth, innovation, and the future of HR in senior care. Hear pivotal moments from Procare’s ten-year journey, lessons learned, and the evolving landscape of workforce management in the industry. 

Gain insight into the need for integrated, accountable partnerships in HR services, and learn how HR can be a strategic driver for quality care. 

Don’t miss this episode filled with leadership insights, industry trends, and big-picture thinking from the heart of senior care innovation.

Want to join the conversation? Follow NIC on LinkedIn.

We want to hear from you! Let us know what you think of NIC Chats by giving us a review on Apple Podcasts, Spotify, or wherever you listen.

Transcript

Lisa McCracken: Welcome everyone. We are live from Austin at the 2025 NIC Fall Conference. We're excited to have you with us here this morning as we are live On the Road for the NIC Chats Podcast, I'm Lisa McCracken, the head of research and analytics with NIC and I feel like you're like a brother from another mother a little. 

This is the fifth consecutive time that we've had Brett with us from Procare HR, and super excited and a lot to talk about here in our time together. And some big announcements recently that you and I didn't even chat about that I want you to share with the audience, but before we dive into our conversation in the next 30 minutes for people that do not know Procare HR and your name has been...I think the first time you and I sat down, the progress and growth you guys have had over the last years is phenomenal. But give everybody the background on yourself your role in the organization, and then a little bit about Procare. 

Brett Landrum: Yeah Brett Landrum, the CEO of Procare HR. I like to describe by talking about the vision first. The vision for our organization is to use HR as an enabler to drive higher quality of care, resident satisfaction, financial performance and growth. 

So everything we do is about how do we construct an HR function where we can measurably drive, really the results that our operators care about. So it's not. Hey, we want to go, sell, sell operators, HR things. We do random things. They pay us money. It's no, we want to sign up to drive excellent results that are measurable for our clients and critical areas of their organization. 

Lisa McCracken: I think the need obviously is significant out there and we're gonna talk about what I describe as a lot of the noise out there for different plug and play solutions and so forth. But what you described is a little different vision, I think, for the role of a company like you in the industry. But, super cool. And I didn't know this until we were preparing for the conversation. This is 10 years for all of you. Again, we've just known each other for two. But for 10 years you guys have been doing this and I don't know the exact stats, but I know the percentage of companies, startups, that actually make it to 10 years is small. So first of all, congratulations. That's a big deal. Talk a little bit about the last 10 years and what that means to hit this milestone. 

Brett Landrum: I don't think about it often really, because you don't really have a rear view mirror and you're always running forward and like looking at what's the next thing? What's the next thing? What's the next thing? But every once in a while, I'll be sitting and like reminiscing on life and I look back's  

Lisa McCracken: Do you remember? 

Brett Landrum: It's oh my goodness. Like I, if you would've told me 10 years ago that the organization, we'd be doing the things that we're doing today like we'd have the focus, the team, the clients opportunities, etcetera. I like in some ways I'd say I wouldn't have been surprised, but it was like impossible for me to conceptualize being at this place. And I'd say, the last 10 years it's been a lot of fun and, continued to accelerate over the last couple of years. But, the longer I'm in this, the more and the older I get, 26-year-old me would've said oh, age doesn't matter, what's wisdom? That's all bs. And 37-year-old me is: man, I've made a lot of mistakes. And like the bigger the company gets, the more I realize I don't know a lot. And so it's been a fun learning journey.  

Lisa McCracken: I think that's the sign of a strong leader for sure. So I do want to talk about the journey a little bit because we often know growth is not like this nice linear, easy path forward. Sometimes it's like the step forward, two steps back, two forward, one back, fail fast, pivot and so forth. Are there any key milestones?  I've got a couple questions around this growth, I think, but first are there key milestones when you think back in the last 10 years that you're most proud of? Or you say that was a really pivotal point for us?  

Brett Landrum: Maybe a little bit higher level. I break our lifetime into three chunks. So there's  the first five years, which is, 2015 to 2021, which was really like trying to survive like, learn a bit, learn business, hiring our first employees making lots of mistakes, really, understanding senior care intimately. And then, the next chunk was, I would say more consistent growth, really focused on product and the executive team. And that was really like ‘21 through ‘24 and then now, ‘25 through, really hopefully in ‘28, ‘29 is really about continuing the march on talent internally. And really I would say, coming into the vision for the business, like for 10 years the whole thing has been about where we are today. 

Which is like we had to do the boring, we had to do the like, check the box HR stuff as a business. But the whole time we've been saying, there's something else here, there's something else here, there's something else here. We don't have the resources. We don't know exactly what it is, but HR is just too pivotal of a function, and it is going to continue to be for operators for like this, not to be this opportunity to really create meaningful value for the industry and for our operators. Like 10 years in, we're finally at the point where it's like. Wow. Like we're seeing incredible labor impact on labor performance with our operators. We're investing heavily in the technology to really leverage the data that we have access to so that we can help our operators start seeing what's the next best move? 

We're just starting to get to that point where it's like the last 10 years has been this big buildup to get to now be able to work on the fun stuff.  

Lisa McCracken: As you look back, are there any things that maybe didn't go as planned the first time where you're like,  

Brett Landrum: Everything. 

Lisa McCracken: Because there's always that decision. It's alright, do we bail and cut our losses, we fail fast or do we know we've got something, we just didn't get it right and like it's that grit to stick with it. So anything where you like, that didn't go or wasn't what we envisioned, but we did stick with it. 

Brett Landrum: So I have a graveyard of bad decisions. But, I would say, so our products, some of our kind of functional areas that we started up, like our labor, our labor management and our talent acquisition we had a lot of missed starts on figuring those out. 

We like fell into both of them a little bit by happenstance, where we had an operator come to us and say, hey, you're taking over our whole HR function, why would you not also do the talent acquisition component? And at the time my view was, because that's the tree you never cut down. And like it's very hard to objectively measure like, how are we doing versus if you had a different resource, etcetera. So we had a handful of miss starts on talent acquisition and same thing on labor. And with a lot of different products. And then, really if I had to look back and say what's the single most frequent mistake I've made? And unfortunately continue to make it's the people, like it is so hard, the talent side of it, particularly in a fast growing company, but in general it's really hard. But, you add meaningful growth and trying new things on top of that, and it makes the people equation a lot more complex. 

Lisa McCracken: And I would think for you that's, that the importance of painting the vision. Sort of what we're working toward, I think is incredibly important during those fast moving times of growth. So you had referenced about some of the growth and some of the different ideas, so yeah, obviously, I'm sure you guys have vision oh, I think the industry needs this, but then I would assume there's times where like the client's Hey, this is a need for ours. 

So it's there's a little bit of a pull towards growth and then you guys pushing because you're like, I know this is what the industry needs. Has it been a little bit of a combination of both and do you have a philosophy on that of what drives that strategy? 

Brett Landrum: So we have the luxury of being in in the, for lack of a better term, heat of the battle with our clients. Like we're in it, like we're in it every day. When we're integrating to the organization, we know what their broader objectives are. We're working with, on building our HR strategy roadmap for each client, based upon what the organizational objectives are and their unique business circumstances. And so, most of what we're building, it iterates or evolves. Our thinking evolves quite frequently, but it's usually scenarios where ah, we're really we would get better results faster if in this really hard to crack case we had access to this information faster or that information, or we could synthesize lots of different pieces that maybe different leaders on our team are getting fragmented and then all of a sudden, like a month later, we all get together and go, oh yeah, this is what we need to do. 

And so much of it is coming, it's a mix of clients giving us suggestions and feedback and then also us just being like relentless about we are going to drive results. What are the barriers to those results and what do we then need to invest in to be better and be able to get results, more broadly and rapidly for clients. Like that's the rally cry.  

Lisa McCracken: I think one thing that's inevitable is change. And when you think back over the last 10 years, where this industry was 10 years ago, where we are today. How would you say the industry has changed and the need, and, 10 years from now it's going to be even crazier. 

Brett Landrum: I'm laughing because I remember when I started out, I literally had an Excel document. It was just like cold calling people. And guess what? People answered their desk phone, a CEO answered the desk phone and, maybe take my call off and not,  

Lisa McCracken: and you're dating yourself when you say desk phone, right? Because now it's all on team's. 

Brett Landrum: I'm using that as a funny example. But how you go to market has changed dramatically. You look at five years ago, like email hammering people with like email spam and blogs and newsletters and all that stuff. That was like an effective like that kind of thought leadership in the email was like the hot thing to do in B2B go to market. And now everybody's tired of getting it's Procare's, thought leadership blog. It's just Procare trying to sell us something. 

So it's just, the industry's changed really rapidly. Obviously the technology landscape has evolved quite a bit I think. I was talking to an operator the other day and it's interesting because like just COVID, there was like, COVID. Then there was like the one or two years after COVID where it's like people trying to get their footing and now we're at this really exciting time where I think operators have regained, got their sea legs back under 'em. 

And it's okay, what can we do now? Cool. And so it's, the conversations we're having, I would say are much less about, Hey, we need help keeping our head above water. It's about how do we advance the organization and really get back to thinking more proactively and like pushing the edge of making the business better. 

Lisa McCracken: That's nice. That sort of the strategic level work. So part of the luxury of growth or the benefit of growth is the ability to bring in certain subject matter expertise, grow your team. And I would say that helps you obviously in the depth of what you're providing to your clients. So where have you focused in terms of your internal hiring and building your team around some of that subject matter expertise? What can you comment on from recent years?  

Brett Landrum: Yeah, so I would say the thing, we made a decision by accident really, I would say in 2017, and we hired our chief now Chief Client, customer Officer Sarah Wilson. She's a former operator. And it was the first person and we had maybe 13 employees at the time, or she was 13 and it was the first person from senior care we hired. And that would seem like a really obvious thing in hindsight, but at the time we hired her, we're like, oh, you really know the industry better than us. Like you can make what we deliver and how we deliver it so much better. And since then, we've really focused, like every one of our service leaders is a former operator. On our executive team we've got three former operators, like we have, 70% of our team comes from senior care and in different ways, shapes and forms. Most of them having been in a clinical kind of operations role. Or, leading, whether it's a community or region or in some cases, a large organization.  

Lisa McCracken: I'm sure that gives you not just the internal knowledge and expertise, but credibility, I would think with prospective clients as opposed to Hey, we know, like HR and all this stuff, but, we don't know the industry or haven't been boots on the ground in the past. 

Brett Landrum: It's really interesting. It has created a level of passion that like I, again, unintended consequence, but like the biggest differentiator. I just was out with our investors last week and they're asking lots of questions and one of them asked Hey, what do you feel like right now is one of the biggest differentiators in the business? 

And I was like, it's unintended. I'm like really thrilled It's happened, but it's culture and it's like we have such an ambitious team and it's because so many of them came from senior care that like they feel it. Like they see the problems and they have this like deep rooted passion for helping our clients, be successful, be better because they're like, I was in that seat. I did the twenty four/seven, I got the call at midnight when, you know, on Christmas when a pipe burst. And it sucks. Like it's really hard. And so if we can do something to make it, to help 'em be better, then, and so that, that's really been, it's been an exciting thing that I've seen, I felt like a lot of momentum in our organization and the culture over the last year and a half.  

Lisa McCracken: That's very cool. So you said she was hired as number 13. I know I asked you before we went live, how many employees do you guys have now?  

Brett Landrum: About 140 

Lisa McCracken: That's pretty cool. That's awesome. So I mentioned earlier the noise. So I think, it's no secret that there are workforce challenges, headwinds, we as an industry need all the support we can get to be strategic on that front, and I would also observe there's a lot of what I'll just call plug and play solutions. We can do this, we can do this. But you guys definitely, and you've touched on this early in the intro, but just have a more holistic view of your role. Can you articulate that again a little bit for people that are listening? 

Brett Landrum: Yeah. I could soap box on this for the rest of our time. So I look at it and the way I have broken this down is you have like tech and SaaS companies who are really selling you a technology product and then, maybe they're providing some degree of implementation support, but then it's yours and the success of that product is really going to be predicated on your business strategy, how it's incorporated into the organization, what's the kind of depth and persistency of use amongst, depending on who the stakeholders are etcetera. Then you've got, like a tech enabled service, which is traditionally where like Procare and like a finance and accounting outsourcing firm with…is we're tech enabled services. We resell tech, don't typically build our own and are providing consistent services and usually in a tech enabled service, it is not to say there's not deep relationships, but oftentimes like you're paying me for a transactional type service that may be big and helpful, but probably isn't, like really doesn't address like a core competency. Or like a core I'd say, capability or metric in the business. It's like we have to hit this and then, what we really have worked on getting to Procare is, we're starting to build our own tech a little bit, some mix of the two, but we're starting to build our own technology in very specific places. Yes, we do tech enabled services, so we do payroll and benefits and all those different things. But then with our clients, we're signing, we're putting our name next to labor right now. And we're saying like, as part, when we go through our diligence and sales process, we're saying, hey, we believe that we can make you more cost effective in your labor function by this number. And you should hold us accountable for that. 

Lisa McCracken: I love that.  

Brett Landrum: And so it's and we're, do we want to do that? And as we grow and continue to invest in, in the organization and getting better, we want to be able to do that in more and more areas. Where we can say, this is an area that like operators really struggle to execute to. 

It's like just providing services doesn't go far enough, because then the operator is still…if you're not accountable for the number and you're just doing some random things to help it, somebody's got to be accountable for the number. And that's what we're trying to do, so it's real, like kind of the next level is, how do we be so integrated with our clients where they're willing to trust us with like critical, execution of critical business functions. 

Lisa McCracken: I love the metrics because that's not just accountability for the partnership, but I think it opens communication and I think really fosters that partnership in a little different way than what it would normally. There are realities right now around workforce. Okay. So I'm talking about the pipeline talent acquisition, just from a number’s standpoint and some of this, I mean it's, I don't want to say decades off. When you look at even the demographics of the birth rates in this country, I think like 2080, the population's going to plateau in the us which is a little wild to think about. I don't think I'll be around then, but, so knowing that there are not just, there's not just a wave of a ton of people potentially coming in the front door, you got to make sure the back door is secure in terms of retaining staff. 

The realities of some of the metrics around workforce and labor, does that change how you're approaching things right now and what you're focusing on? I'm not trying to be Debbie Downer, but there's some realities.  

Brett Landrum: It drives, it literally drives everything we focus on. And the reason is, I don't mean to be flippant when I say this, like there's not enough workers for the industry. But there are enough workers for our clients. And I don't mean to be overly flippant, but if the industry is like 20, 30% understaffed, like there's enough, there's sufficient workers for us to have whatever, 10% of the market and support our clients and being successful. 

Now there's obviously I, that's like a very big broad sweeping statement and like I can say that and then, the community and middle of nowhere, Idaho is okay, Brett, you say that, but unless you're like, flying in people from Minneapolis I'm not sure but broadly speaking like we look at it and say, how does HR provide a differentiate advantage for our clients? 

And so if we know there's a big work, a workforce crisis and every operator is fighting and not like both within the industry and with fast food and other types of healthcare for workers. Hey, this is the thing we have to be good at. 

How do we go and acquire employees? How do we make sure we're effectively staffing them? And then there's this whole big bucket of like, how do we retain them? That has, lots of variables and complexity and everything else.  

Lisa McCracken: Okay. We're coming down to the last few minutes left. You had a big announcement last week and I actually have the announcement printed off here. Partnership in a pretty big way with Foresight. Talk to us about that. What's the vision for that?  

Brett Landrum: Yeah, so we acquired Foresight last Friday. It's something Steve and I have bounced around the idea for a couple of years. 

And the way I think about this is look, like Procare, this is all we do is, this industry and we are a disruptive, kind of non-traditional way to solve problems, from a partnership perspective. And when I thought about what Steve does and the opportunity we have is, okay, we can do really good, do good for the industry, which is invest heavily in enhancing the thought leadership of his platform, bringing on more, I would say like brand ambassadors, getting more specific with like kind of topic channels. And then, look the positive byproduct of that to Procare is market awareness. And, if the industry as a whole is focused more on how do we continue to be better my strong belief is it will open people's hearts and minds, considering Procare more frequently, just because some of the opportunity, the resources that we can bring to the table.  

Lisa McCracken: What I see in this is a commitment to the industry. And I think that's very cool. And you guys are looking to, just think differently and in a really big way about influencing the sector. 

One final question before we wrap up. Okay. 10 years from now, so it's 2035. What's Procare gonna look like? That's like a big picture question. We're handled that one. 

Brett Landrum: Procare, likely, it's not just HR, so we're in other areas where operators need partnership and they need focused resources to execute really well, to help 'em be better. I have some ideas that some of what, some of those things are, but I'd say not fully baked. And then, I think there's a lot of paths to get there, but the thing that's really important to me is quality of care, labor results, financial results, resident satisfaction and growth. We have like our key metrics underneath each of those. We are executing on a consistent basis to those metrics that we can measure and say, Hey, look, Procare has, whatever, 2, 3, 400 operators that we partner with across a hundred, 200, two or 300,000 employees. 

And here's what we're consistently able to do in all of these areas. And we can prove that hey, one Procare's going to impact your turnover and it's going to drop by 30%. And because we did that, look we've measured, because we pulled all your HR data in that, turnover went down and quality of care went up. 

And so that's where we want to go. I'd say the path to getting there is a little bit hazy, but we've got a lot of exciting things in the works that I think will at least continue to give us clarity on how to get there.  

Lisa McCracken: Amazon started with books. No pressure. That's awesome. Thank you. It's been a pleasure.  

Brett Landrum: Thank you so much.  

Lisa McCracken: So thank you all for listening. Again, NIC Chats live on the road in Austin, and excited to have Procare HR once again. Great seeing all of you. Thanks again, Brett.